Italian prosecutors are examining fresh evidence that suggests coronavirus was spreading in the country weeks before the first case of local transmission was officially detected as criminal investigations continue into continental Europe’s deadliest outbreak.
Lawyers representing the families of Covid-19 victims say the medical records of a man in his 50s who was admitted to a hospital with bilateral pneumonia at the end of January 2020 in Bergamo, the Lombardy province severely hit during the first wave of the pandemic, “could change the timeline of the pandemic in Italy”.
“The impact of this possible negligence is that many deaths could have been avoided,” said Consuelo Locati, representing families in two legal cases. “And if this was a choice that came from high up, like a political choice, it would mean people were killed by politics more so than the virus.”
According to the medical records seen by the Guardian, the patient was discharged on 17 February, four days before Italy’s first locally transmitted infection was confirmed in Codogno, a Lombardy town south of Milan.
Before the Codogno case, two Chinese tourists from Wuhan, who arrived in Milan on 23 January before being hospitalised in Rome a week later, had been the only confirmed Covid-19 patients in Italy.
Italy was the first country in the western world to be engulfed by the pandemic, and has the highest Covid-related death toll (127,649 as of Sunday) in Europe after the UK.
At the time of the diagnosis in Codogno, coronavirus testing was only for those who had travelled to China within the 14 days prior to initial symptoms. But, according to guidelines published by the health ministry on 22 January 2020, testing was also supposed to be done on those “with an unusual and unexpected clinical course, especially if followed by an abrupt deterioration despite adequate treatments, irrespective of their place of residence or travel history”.
The Bergamo patient had developed symptoms of “coughing, with a fever” days before being admitted to hospital in the town of Seriate, according to the medical records. A CT scan of the patient’s lungs showed “the left lung had shaded parenchymal thickening looking like ground glass”. The results of the scan reflected features of Covid-19 in patients who had either clinical or radiological evidence of pneumonia.
Prosecutors in Bergamo will now need to verify whether a test for Covid-19 was done on the patient, as part of their investigations into criminal negligence by Italian authorities in the handling of the pandemic. If a test was not carried out, they will need to establish if the pandemic guidelines specified by the health ministry were violated by the local health authority.
Five health managers in the Lombardy region and a former director at the health ministry who are under investigation by prosecutors have denied any wrongdoing.
The new evidence will also be presented in the first hearing at Rome’s civil court on Thursday in a case brought by the same group of families as they seek a total €100m in compensation from the Italian government.
Locati said she is convinced the evidence gathered so far represents “solid proof of systemic negligence”.
“And [the medical records] show how coronavirus might have spread undetected for at least one month in Italy due to a lack of compliance with the guidelines on epidemiological surveillance,” she added.
At the start of the pandemic in Italy, doctors said they believed the virus had been circulating in the country for weeks before it was officially detected. Some medics in Lombardy, by far the region worst affected, reported seeing cases of “strange pneumonia” in patients dating back to late December 2019.
Annalisa Malara, an anaesthetist at Codogno hospital, pushed for Mattia Maestri, an otherwise healthy 38-year-old who became known as Italy’s “patient one”, to be given a Covid test after seeing images of his lungs on 20 February 2020. Maestri was not tested before then as he had not travelled to China prior to becoming ill. His Covid-19 diagnosis was confirmed on 21 February 2020.